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DEAR MAYO CLINIC: My mother had a stroke six months ago. Her mobility has returned to near normal, but she still has some difficulty communicating. She can read and understand others when they speak, but she often struggles to find the words she wants to say. While frustrated, she refuses to try speech therapy, saying it will not help. Could speech therapy help someone like my mother?
ANSWER: The effectiveness of speech therapy for people who have communication difficulties after a stroke depends on many factors, including which area of the brain the stroke affected, the severity of the brain damage, the person's awareness of his or her difficulty, and the ability to learn and apply strategies. Generally, speech therapy can help those whose speech is affected by a stroke just as other types of rehabilitation can help them if they have to relearn other skills lost due to a stroke.
Strokes can affect speech, which is the physical production of sounds, and language, which is the mental representation of words, their meanings and the rules for combining words. People who experience a stroke can have difficulty with speech, language or both.
Finding words is part of language. The medical term for language difficulty due to a stroke is "aphasia." Aphasia can affect a person's ability to comprehend what they hear or read, find words, appropriately combine word forms, and form full sentences. Aphasia, which can be a significant barrier to clear communication, often leads to frustration.
Working with a speech-language pathologist can help. The goal of speech and language therapy for aphasia is to improve communication by restoring as much language as possible, teaching how to compensate for lost language skills, and learning other methods of communicating.
Speech-language pathologists, who are sometimes called speech therapists, use various techniques to improve communication. After initial evaluation by a speech-language pathologist, rehabilitation can include working one on one with a speech-language pathologist and participating in groups with others who have aphasia. The group setting can be particularly helpful because it offers a low-stress environment where people can practice communication skills, such as starting a conversation, speaking in turn and clarifying misunderstandings.
A speech-language pathologist also can direct your mother to resources she can use outside of speech-language therapy sessions, such as computer programs and mobile apps, that aid in relearning words and sounds. Props and communication aids, such as pictures, notecards with common phrases, and a small pad of paper and pen, often are encouraged as part of speech-language rehabilitation and can improve a person's ability to convey his or her thoughts.
You, other family members and friends also can help your mother rebuild her communication abilities. Consistently include her in conversations. Give her plenty of time to talk. Don't finish her sentences for her or correct errors. Keep distractions to a minimum by turning off the TV and other electronic devices while you talk. Allow time for relaxed conversation.
Recovering language skills can be a slow process. With patience and persistence, however, most people can make significant progress, even if they don't completely return to the level of function they had before a stroke. It is important to seek treatment for aphasia because if left untreated, communication barriers can lead to embarrassment, relationship problems and in some cases depression.
Continue to encourage your mother to make an appointment with her health care provider to discuss speech-language therapy. They should be able to help find a speech-language pathologist who has experience working with people who have had a stroke. — Dr. Heather Clark, Neurology, Mayo Clinic, Rochester, Minnesota